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Targeted Muscle Reinnervation

Working on a parallel track, DARPA's Reliable Neural-Interface Technology (RE-NET) program aims to improve the speed and reliability of neural interfaces. Such interfaces can happen in the brain, as in the case of Hemmes, or someplace else farther down the line, closer to the missing limb, as in the case of Targeted Muscle Reinnervation (TMR).

Developed by Dumanian and Kuiken, doctors at the Rehabilitation Institute of Chicago, TMR enables mechanical arm movement by taking nerves that once carried motor signals from the brain to the missing arm and connecting those nerves to others located near a large muscle, such as the biceps or pectorals. When a TMR patient thinks about moving his hand, the resulting command is actually routed to his chest muscle. This muscle serves as a biological loudspeaker, booming an electromyography (EMG) signal to external electrodes placed on the skin. When the electrodes pick up that signal, processors translate the EMG into useful information, which drives the myoelectric arm.

Since TMR does not require brain surgery, it's an ideal option for patients missing limbs. In addition, TMR can?at least in the lab?provide tactile feedback. This is a function of pressure gizmos called tactors in the bionic arm and the rewired nerves, which send sense data back to the brain. "Basically, TMR creates an ‘image' of the hand on the chest," Dumanian says. "So when the patient is touched there, he feels it as his hand."

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